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General NPI Number Information
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NPI Number | 1255452785
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Entity Type | Organization
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Legal Business Name | GEORGE MED PEDS ASSOCIATES, P.C.
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 09/03/2010
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Provider Practice Location Address
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Address Line | 6252 S RAINBOW BLVD SUITE 110
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City | LAS VEGAS
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State | NV
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Zip | 89118-3248
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Country | US
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Telephone | 702-253-5410
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Fax | 702-433-5410
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Provider Business Mailing Address
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Address Line | 2725 S JONES BLVD SUITE 100
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City | LAS VEGAS
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State | NV
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Zip | 89146-5605
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Country | US
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Telephone | 702-253-5410
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Fax | 702-433-5410
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Authorized Official
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Title or Position | OWNER
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Name | DR. CONSTANTINE GEORGE
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Credential | M.D.
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Telephone | 702-253-5410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 11122
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 11122
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License Number State | NV
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